Achilles Tendon Rupture Treatment - Postcode Lottery?
Posted , 24 users are following.
Hi All,
First time poster here.
I wanted to find out a little more about various NHS trusts treatment of Achilles Tendon Rupture (ATR). I'm especially interested as I get the feeling the treatment on offer to me is not optimal and I wonder if I'm the victim of being under the wrong trust. One that is trying to save costs.
My Background : 44 yo male, healthy and fit, with suspected ATR. currently 3 weeks in short leg cast.
I have an Ultrasound tomorrow (4 weeks after incident). No Surgery being offered at all, Consultant says they only provide conservative treatment with cast as surgery gives to many risks. Treatment is 3x3 weeks of short leg casts, final cast is 90 degree to floor. It seems no load to be applied at all during this time.
My main concerns are :-
(1) Risk of re-rupture seems to be on average 20% with non surgical option.
(2) 1 in 3 patients on non surgical never recover function fully.
(3) No option of Airboot being offered to me.
(4) Various studies show that early restricted mobilisation of ankle in non surgical option reduces chance of RR to same levels as surgical. This will obviously not be available if I'm in cast for 9 weeks.
(5) I don't see how I can be offered a set treatment path prior to Ultrasound.
I've never heard of 3x3 weeks cast only option. What are you being offered? I'm absolutely not going to settle for walking with a limp or a weakened leg because my trust are watching their pennies. I will be taking a private second opnion but also wanted to hear your thoughts?
Thanks
David.
1 like, 109 replies
pacehuman david97308
Posted
Did you had Partial Rupture or full rupture?
david97308 pacehuman
Posted
I've been in a cast for the 4 weeks.
pacehuman david97308
Posted
mandy1956 pacehuman
Posted
Hi David
I am also 3 weeks into my rupture, i also was not offered surgery.
When it happened the accident and emergency department put it in plaster right away and told me to make an appointment with the Orthapedic department for a weeks time. I could not get an apointment with them for 11days, anyway i attended my appointment and have also now been give 3 x 3 weeks in plaster with no weight bearing. By the time the plaster comes off i will have had it plaster for nearly 11 weeks. How are you coping ??
Mandy x
pacehuman mandy1956
Posted
So strange that NHS is different every where when i had my partial rupture straight away i had x ray then ultra sound and then cast for 2 weeks, after that every 2 weeks fracture clinic visit and they removed cast and put new one.
Today it is been 6 weeks and cast is off and i am walking with normal shoes, just bit tight felling on the calf and tendon Achilles and Cons said its normal
Imran
david97308 pacehuman
Posted
pacehuman david97308
Posted
How can you accept this attitude?
david97308 mandy1956
Posted
I'm more concerned with the treatment I'm being offered.
Have you had an ultrasound? How did they determine it was a rupture or tear?
pacehuman david97308
Posted
mandy1956 pacehuman
Posted
Hi Imran
I know the treatment is so different , I was xrayed on the night it happend the see if i had broken anything, but have not been offered an ultra sound or mri scan, it's fantastic that you are walking after 6 weeks
Mandy x
pacehuman mandy1956
Posted
mandy1956 david97308
Posted
Mandy x
karen42768 david97308
Posted
I ruptured my Achilles' just over 7 weeks ago. Protocol is sooooo different everywhere in the world so it seems. I was put in an Airboot straight away until I had a scan which was not until 9 days later. After my ultra sound I was told I did not have a complete tear, although before that I was offered either conservative or operative options and booked in for an op without the scan; I pushed for the scan. My doctor at the hospital said he would op for an op but that's because he prefers that option, I decided againist it. I was then sent home with 4 heel lifts in my boot and told to take one out every 2 weeks, one goes on Wed and then one heel lift left, back to hospital at end of July and Physio booked in a week later. I ahve started doing my own exercises and my foot feel OK. Using one crutch now and with the aid of my wedge shoes to bring my other foot to the right level of the boot can just about do some walking unaided. I feel I am now on the road to recovery but with no aid from the hospital. I would question as to why you are not getting a scan before week 4 and would worry about this as you don't know how bad your rupture actually is. Hope you get sorted quickly.
Karen
Ploddingon david97308
Posted
So sorry for what you're going through atm and that I can't offer you any helpful information.
I haven't actually suffered a ruptured tendon but Tendinopathy in both Achilles' tendons and all other tendons in my ankles and feet. This was due to taking an antibiotic Levofloxacin, in the Fluoroquinolone class and tendon problems, including ruptures, are a common Adverse Reaction - particularly affecting Achilles. This ADR is often delayed, only occurring months after stopping the antibiotics.
I am interested in finding out if people with Achilles' tendons rupture, might be experiencing an adverse reaction, so if you have taken a Fluoroquinolone/Quinolone antibiotic in the last year, I would appreciate if you could let me know.
In the meantime, I wish you a speedy recovery.
plodding on
joanne74472 Ploddingon
Posted
I took Levaquin periodically for a total of about 3 weeks from January 2014 through March 2014. What I thought was Achilles tendonitis/tendonosis/tendonopathy got progressively worse until crutches were needed.
Had MRI done in May which showed 9 mm Achilles tear along with inflammation throughout ankle and foot. Was given airboot for 8 weeks and a second MRI shows the tendon has not grown back even a fraction of an inch. Was not given heel lifts to wear in airboot as others have explained.
Just wanted you to know that the Achilles can tear easily, without an injury, anytime after taking a fluoroquinolone.
Hope this doesn't happen to you - in either foot.
JoAnne
Ploddingon joanne74472
Posted
sorry you have been suffering with Achilles problems after Levaquin and I'm not surprised to hear that it did not heal as the medics expected. This is because the damage is different from that caused through sports injury etc, the collagen has degraded and this takes a long time to grow and knit together again.......it never will be as strong as it was before the damage but trying to get the docs to understand this is something else!
i know that after taking an FQ and especially having a reaction involving tendons, in particular, the Achilles, that there is risk of tendon rupture for a year or so after stopping the FQ......it's scary and worrying and we have to be mindful of this danger, once we see recovery happening. It is easy to get carried away and think the tendons are out of danger...because they are not.
you might want to check out the conversations about Ciprofloxacin, as it's an Fluoroqunolone, like Levaquin.
good luck in your recovery and thanks for the warning. Although I was already aware of this, it is always good to be reminded and for others to be made aware too.
take care and keep in touch
plodding on x
joanne74472 Ploddingon
Posted
Thanks so much for your response ! Are you a doctor or other medical professional ? If not, it's a sad commentary on the profession that I have obtained more education from a nonprofessional than received from three doctors.
Had no idea regarding the degradation of collagen. Only wish that I'd found this website and read your post while using the Levaquin last winter - would have been much more careful and probably not ruptured - doing all kinds of stupid things like cross country skiing.
Glad that you know re potential for rupturing.
Thanks again for the valuable info.
Hope yours is beginning to heal (sorry).
JoAnne
Ploddingon joanne74472
Posted
No I have absolutely no medical background but like many Floxed (the term given to those affected by FQs) I have become an expert on this subject! We have had to learn ourselves and help eachother, because the medical profession can't/won't help. A few are willing but there is no cure or even any aids for recovery from these adverse reactions.
How are you feeling now and have you noticed any other strange symptoms generally, which you can't account for? If so, then consider that the Levaquin is still doing it's damage.
i hope you've checked out the other conversations about these antibiotics and also, if you use Facebook, there are a few info/support groups.
Are you in the UK?
sorry for so many questions
plodding on x
joanne74472 Ploddingon
Posted
Thanks so much for your response. It's good to know that there is someone else - that not alone in this - certainly the medical profession here is not providing any support.
I live in the US in the state of Ohio, on Lake Erie - 34 miles from Ontario (across the lake). Used to frequently sail my boat across the lake to Canada.
Ever since the prolonged Levaquin use last winter and spring, I've been acquiring these strange lumps, or something, in some of my muscles. One feels like it's imbedded in the soleus muscle of same leg that Achilles is ruptured. MRI report called it a ",masslike fatty replacement of the soleus muscle". it only hurts when turn leg a certain way - but is excruciating if grab the calf muscle. Ever heard of this ?
Didn't think the medical profession would explain it.
In past several months have been developing these lumps (some harder than others) in other muscles. The ones in biceps cause constant moderate pain and excruciating pain when using arms for anything.
Will look on Facebook for support groups.
Thank you so much.
JoAnne